Predictors of International College Students' Formal Help-Seeking Grounded in Andersen's Behavioral Model

Since 2022, international college student (ICS) enrollment in US higher education has increased significantly. Although literature highlights patterns and rates of ICS mental health service utilization, evidence regarding theory-driven predictors remains limited. Grounded in Andersen's Behavioral Model of Health Service Use (ABMHSU), this study investigated factors predicting formal mental health service utilization among ICSs. The sample included 1400 ICSs from a mid-sized private university. Using ABMHSU, we tested three hierarchical logistic regression models incorporating predisposing factors (i.e., gender identity, gender and sexual minority status, academic level), enabling factors (i.e., loneliness, relationship status, resilience), and need factors (i.e., psychological distress, suicidal ideation [SI]). Results indicated that male-identifying students had lower odds of seeking formal support, whereas students identifying as gender or sexual minorities demonstrated higher odds. Furthermore, our analysis showed positive associations between loneliness and SI and the likelihood of formal service utilization. These results underscore the need for counseling practice and system-wide advocacy initiatives.